Hamstring Strains

Hamstring injuries are common in the athletic population. Participants in track, football, basketball, soccer, and baseball are especially prone to this injury, given the sprinting demands of the sport. Dancers and those in martial arts have a similar susceptibility due in part to the extreme stretch on the hamstring. Slow or fast “stretching” has been shown to injure this muscle.

Hamstring injuries are commonly classified according to the degree of damage associated with the injury. Grade 1 (mild) and grade 2 (moderate) strains are most common in the athletic population. A grade 3 (severe) strain represents a complete hamstring tear and may result from a traumatic event (i.e. falling while water skiing).

 

 

Running-related hamstring injuries typically occur in the mid-part of the muscle, where as activities such as kicking, dancing, or over stretching will cause injury to the “tendon” portion of the hamstring close to its attachment on the pelvic bone. Injury to the tendon portion will typically take longer to recover and quite commonly makes it difficult for the individual to sit.

The average number of days lost from activity or sport following a hamstring injury is typically 8-25 days, depending in part on the injury severity and location. Unfortunately, nearly 1/3 of hamstring injuries will re-injure. The greatest risk of re-injury is during the initial 2 weeks once an athlete returns to sport. This high early re-injury rate may be suggestive of an inadequate rehabilitation program or a premature return to sport, or a combination of both.

The proper rehabilitation approach for hamstring injuries has certainly evolved over the last decade. Some traditional approaches have included ice, heat, electric stimulation, massage, and stretching. While this approach may provide some pain control following the injury, it has not proven to be effective in the long-term. A current, more comprehensive approach would include eccentric strength training for the hamstrings, gluteal muscle training, and strength/coordination exercise for the core. This approach is progressed through 3 specific phases with the goal of returning the individual to pre-injury status.